Systems of Care; Complex Adaptive Systems; family systems; wraparound services; community mental health


Systems of Care (SOCs) are distinctive among health care organizations because they focus on process as much as outcomes and consider families as equal partners in improving clients’ outcomes. Because SOCs attend to interactions among all aspects of the clients’ world, we may think of them as ecosystems with continually changing environments. “Theories of Change” (TOCs) are logic models that structure and coordinate SOCs’ conceptualization, implementation, evaluation, and adaptation. Of these elements, current SOC literature is least focused on adaptation, though adaptive practices are vital to addressing clients’ interests. A Complex Adaptive Systems model is used to analyze an exemplary SOC’s Theory of Change to show how analyzing well-defined adaptive strategies within organizations is critical to uncovering the most valuable elements, processes, and innovations for working effectively with at-risk families, given their specific context.

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